Browsing by Author "Pakai, Annamaria"
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- Effects of Hormonal Replacement Therapy and Mindfulness-Based Stress Reduction on Climacteric Symptoms Following Risk-Reducing Salpingo-OophorectomyPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A.; Laranjeira, Carlos; Amer, Faten; Hallit, Souheil; Alkhamees, Abdulmajeed A.; Aljubilah, Aljawharah Fahad; Aljaberi, Musheer A.; Alzeiby, Ebtesam Abdullah; Fadlalmola, Hammad Ali; Pakai, Annamaria; Khatatbeh, HaithamBreast Cancer Associated Susceptibility Proteins Type 1/2 (BRCA1/2) promote cellular functioning by modulating NRF2-mediated antioxidant signaling. Redox failure in women with BRCA1/2 insufficiency increases the risk for breast/ovarian/uterine cancers. Risk-reducing salpingo-oophorectomy (RRSO) is a prophylactic surgery of the reproductive organs, which is frequently conducted by the age of 40 to lower the occurrence of cancer in women with BRCA1/2 mutations. However, abrupt estrogen decline following RRSO causes ovarian failure, which implicates various cellular physiological processes, resulting in the increased release of free radicals and subsequent severe onset of menopausal symptoms. Comfort measures (e.g., hormonal replacement therapy (HRT) and mindfulness-based stress reduction (MBSR)) may improve chronological menopause-related quality of life, but their specific effects are not clear in women with gene mutations. Aiming to fill the gap, this study used path analysis to examine the effects of HRT and MBSR on menopausal symptoms among RRSO patients (N = 199, mean age = 50.5 ± 6.7 years). HRT directly alleviated the levels of urogenital symptoms (β = −0.195, p = 0.005), which mediated its indirect significant effects on the somatic–vegetative and psychological symptoms of menopause (β = −0.046, −0.067; both p values = 0.004, respectively), especially in BRCA2 carriers and in women who were currently physically active, premenopausal at the time of RRSO, had a high BMI, and had no history of breast cancer. It increased the severity of urogenital symptoms in women with a history of cancer. MBSR, on the other hand, was associated with indirect increases in the intensity of the somatic–vegetative and psychological symptoms of menopause (β = 0.108, 0.029; p = 0.003, 0.033, respectively). It exerted positive direct effects on different menopausal symptoms in multigroup analysis. The results suggest that young women undergoing recent RRSO may benefit from HRT at an individual level, while their need for extensive measures to optimize their psychological wellbeing is ongoing. The adverse effects of MBSR, which are captured in the present study, imply that MBSR may interfere with redox sensitivity associated with estradiol fluctuations in BRCA1/2 carriers. Investigations are needed to test this hypothesis and elaborate on the underlying mechanisms in these women.
- Psychometric evaluation of the Arabic version of the Eight-item Center for Epidemiological Studies Depression Scale (CESD-8): Specific cultural considerations for the assessment of depressionPublication . Ali, Amira M.; Al-Dossary, Saeed A.; Fekih-Romdhane, Feten; Alameri, Rana Ali; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alkhamees, Abdulmajeed A.; Aljaberi, Musheer A.; Pakai, Annamaria; El-Gazar, Heba EmadBackground Despite extensive evaluations of the Center for Epidemiological Studies Depression Scale (CESD), its shortest version, the Eight-Item version (CESD-8), is less investigated, with absolute lack of information on its psychometric properties in the Arab world. Methods To fill the gap, data collected via an anonymous online survey from Saudi samples of students (N = 979, 422) and employees (N = 314), were analyzed through exploratory factor analysis, confirmatory factor analysis, and multigroup analysis to examine the structure and measurement invariance of the CESD-8. Convergent validity and internal consistency tests involved correlating the CESD-8 with its subscales, item analysis measures, and intra class correlations. Criterion validity tests involved correlating the CESD-8 and its subscales with a single-item measure of happiness. Results Exploratory factor analysis produced two factors (negative affect and positive affect) with eigen values >1, which explained 86.4 % of the variance. In confirmatory factor analysis, the crude exploratory factor analysis model had good fit while the fit of the unidimensional CESD-8 and another two-factor structure (depressed affect and somatic complaints) was improved by correlating the residuals of the items of positive affect (CESD4 and CESD6). A three-factor model (depressed affect, somatic complaints, and positive affect) expressed the best fit in the absence of error correlations. This model was invariant across groups of students and employees, gender, and age. The scale and its three dimensions demonstrated adequate internal consistency (alpha coefficient range = 0.65–0.89), convergent validity (item total correlation range = 0.43–0.80 and range of correlations with the CESD-8 = -0.68–0.92), and criterion validity (range of correlations with happiness scores = -0.40–0.60). Conclusions The CESD-8 is a valid short scale for quick identification of people with depressive psychopathologies. Using the CESD-8 to detect heterogenous depressive symptoms, rather than assessing depression as a whole condition, may influence our understanding of the dynamics and treatments of depression in specific groups/cultures, with emphasis on absence of positive affect in the definition of depression among Arabs. Replications of the three-factor structure in different cultures are needed.